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After Limerick case, medics write to every TD to warn ultrasounds must be provided before abortion

Doctors, Nurses, and Midwives have written to every TD in the Dáil, and to every Senator, to urge them to take "immediate action" to ensure that an ultrasound is provided before abortion pills are prescribed to women after a woman almost died in a case presented by Limerick Maternity Hospital.

One medical expert told Gript that the case could not be "swept under the carpet", and that if the Minister did not act "women's lives could be endangered".

Last week, Consultant Obstetrician Trevor Hayes, commenting on the case said that it was "paramount" that ultrasounds be provided when women were being prescribed abortion pills, which usually happens in a GP or women's clinic.

Now, in a letter sent to every TD and Senator last week, Doctors for Life has said that they wished to bring "this alarming case" to the attention of public representatives, and urged them to "take action".

The case, written up by medical experts working in Obstetrics and Gynaecology in the March edition of the Journal of the Irish Medical Organisation, said that it provided insights into “a serious and life-threatening event" described as "maternal collapse due to a ruptured EP [ectopic pregnancy] after a termination of pregnancy".

The woman was brought by ambulance to University Maternity Hospital Limerick suffering severe pain and in hypovolemic shock – an emergency condition in which severe blood or other fluid loss makes the heart unable to pump enough blood to the body, which can cause many organs to stop working.
She was gravely ill, and in a life-threatening situation, requiring “immediate resuscitation” before having her ruptured fallopian tube removed.

The woman had been prescribed abortion pills, but – as is routine practice – the GP had not performed an ultrasound, and the fact that her unborn baby was lodged in her fallopian tube, and not her womb, was therefore missed.

Doctors for Life asked TDs to "please urge the Health Minister Stephen Donnelly to read the case, to take heed of the warnings from medical experts, and to change the policy immediately to ensure that GPs and clinics perform ultrasounds before prescribing abortion pills. In 2018, the amendment to request routine ultrasounds prior to prescribing abortion pills was rejected".

"We call for an immediate action to ensure that women are routinely offered an ultrasound prior to a medical abortion to rule out ectopic pregnancy," they said.

Nurses and Midwives for Life warned that "an ectopic pregnancy and it is extremely dangerous, because, as the baby grows, the tube can rupture leading to massive bleeding, organ failure, shock, and death".

They said there was an "urgent need for policy change or women might die" - adding: "If we say we really care about women irrespective of our position on abortion, then this practice needs to change immediately".

Identifying the symptoms of an ectopic pregnancy – abdominal pain, vaginal bleeding – is key to diagnosis and life-saving intervention. But if a woman who has an ectopic pregnancy has taken abortion pills prescribed by her GP, and no ultrasound has been performed, then the symptoms of the rupturing tube can be mistaken at first for the symptoms of the abortion pill.

Speaking to Gript, Mary Fitzgibbon of Nurses and Midwives for Life said that it would be "completely unacceptable if this alarming case, which has pointed to a very serious, life-threatening flaw in the abortion process, is ignored or swept under the carpet".

"If the Minister does not act, then women's lives will be endangered and women may die. That was made very clear in the case report published in the Irish Medical Journal, when these medical experts said that women may die if the practice of not providing routine scans continued," she said.

“It would be a major scandal if this case was ignored," she added. "The media also needs to put its biases aside and focus on protecting women's lives."

Dr Trevor Hayes said last week that the decision to refuse an amendment proposed by Carol Nolan TD in 2018 to ensure an ultrasound before taking prescribed pills was a "political and not medical decision" in his view.

 

   

Máirín de Barra

     


This article was published in Gript and is printed here with permission

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